Suprapubic Catheter

Information for patients, relatives and carers

 For more information, please contact:

Your community nurse or family doctor
General Surgery and Urology
York Hospital
Wigginton Road, York, YO31 8HE
Telephone: 01904 631313

Scarborough Hospital
Woodlands Drive, Scarborough, YO12 6QL
Telephone: 01723 385246

Malton Hospital
Middlecave Road, Malton, YO17 7NG
Telephone: 01653 604611
What is a Suprapubic Catheter?
A suprapubic urinary catheter is a hollow, flexible tube
that drains urine from your bladder. It is inserted through
a small cut in the abdominal wall just above the pubic
bone: This is done by a doctor in hospital.

To prevent the catheter falling out, a small balloon at the

catheter tip is inflated inside the bladder by a syringe of
water.

As urine fills the bladder, it drains down the catheter and

is collected in a drainage bag attached to your leg.

If the catheter is blocked in the first 12 weeks of

insertion, it should only be attended to by a consultant or
doctor at the hospital and not changed by the District
Nurses.

Page 2
Should the catheter fall out please attend accident and
emergency as soon as possible.

Your first change of catheter is usually between 8 to 12

weeks. This is usually done in hospital. The change will
be organised by your consultant, or the specialist
urology nurses.

There are several reasons why a suprapubic catheter

may be more convenient for you. You may find it more
comfortable, and easier to care for than a catheter that
fits up the water pipe (urethra).

There are fewer risks of problems with a suprapubic

catheter, compared to a urethral one.

Everyday life doesn’t stop because of the catheter, tube

and bag. Normally, there is no reason why you should
not participate in activities you were previously involved
in. The catheter should not greatly restrict your
independence.

When you are discharged home, the hospital would

have booked a District Nurse to come to your home to
check the catheter and supply you with bags and
dressings.

Page 3
Are there any side effects or risks?
Most procedures have a potential for side effects.
Inserting a Suprapubic Catheter is an open operation
that carries risk. You should be reassured that, although
all these risks well recognised, the majority of patients
do not suffer any problems after a urological procedure.

Common (greater than 1 in 10)

• Temporary mild burning or bleeding at the catheter
insertion site or during urination, making blood
appear in the urine collecting bag

Occasional (between 1 in 10 and 1 in 50)

• Infection of the bladder requiring antibiotics
(occasionally recurrent infections)
• Blocking of the catheter requiring unblocking
• Bladder discomfort/pain
• Persistent leakage from the water pipe (urethra),
despite the catheter
• Development of stones and debris in the bladder,
causing bladder blockage and requiring evacuation or
crushing by be a further procedure

Rare (less than 1 in 50)

• Bleeding requiring irrigation or additional
catheterisation to remove blood clot
• Rarely damage to surrounding structures, such as
bowel or blood vessels with serious consequences,
possibly requiring additional surgery or even a bowel
stoma (colostomy).

Page 4
Hospital-acquired infection
• Colonisation with MRSA (0.9% - 1 in 110)
• Clostridium difficile bowel infection (0.2% - 1 in 500)
• MRSA bloodstream infection (0.08% - 1 in 1250)

These risks are no higher than if you had a catheter put

in the urethra (water pipe).

The rates for hospital-acquired infection may be greater

in high-risk patients e.g. with long-term drainage tubes,
after removal of the bladder for cancer, after previous
infections, after prolonged hospitalisation or after
multiple admissions.

If you have had tummy (abdominal) surgery or

radiotherapy before, we may need to make an extra cut
(incision) during the operation. This is so that we can
make sure the catheter is put in safely. We may
recommend that you have an alternative to a suprapubic
catheter if you have internal scarring from previous
surgery or radiotherapy.

What are the alternatives to having a

Suprapubic Catheter?
Catheter through urethra, permanent urinary diversion,
intermittent, self-catheterisation.

Page 5
Drainage Bags
Your catheter will usually be attached to a bag that is
then attached to your leg, by either straps or an
elasticated sleeve. Some bags can be attached at the
waist. Either way, the bag should be well supported so
that it does not pull on the catheter.

The bag is worn under your normal clothing and should

only be disconnected from the catheter when you
change it every five to seven days.

The catheter and bag together make a ‘closed system’.

If bacteria get into this system, there is a chance of you
getting a bladder infection.

At night time, the leg bag can be connected to an

overnight bag as this holds more urine and will prevent
you from having to get up in the night to empty the bag.
This bag is usually disposable and you will need to
attach a new bag to your leg bag every night. Always
ensure the tap at the bottom of your bag is open to allow
flow into the night bag while you are asleep.

Avoid contact of the bag with the floor. Bags should

always be positioned below the level of the bladder to
reduce the likelihood of backflow.

Some patients may be suited to the use of a catheter

Fli, Flo valve, instead of having a bag. Ask your nurse
for further information.

Page 6
Emptying the Bag
As the bag fills up, it gradually gets heavier and you will
feel a strain on the straps or sleeve. It should be
emptied when about two thirds full.

To empty the bag, first wash your hands. The tap at the
bottom should be opened to drain the urine into a
flushed toilet, or a clean and dry container kept
specifically for that job. Take care not to touch the toilet
or container with the tap.

If you are in a residential care home, a member of staff

will wear gloves to empty your catheter.

Close the tap again when you have finished and wash
your hands again.

The night bags are usually disposable and you need to

use a new one each night. You will need to empty the
bag before disposing of it. After you have disconnected
the bag, tear one of the top corners and follow the
instructions above for emptying. Please dispose of in
household waste bin.

You will be shown by the hospital or district nurse how to

attach and remove your night bag correctly.

Page 7
Changing the Bag
Your community nurse or ward nurse will help and guide
you through this procedure initially.

You should change the leg bag once every five to seven
days. Usually the overnight bag will not have a tap and a
new one should be used every night

To change the bag:

• Wash and dry your hands

• Unwrap new bag and loosen the cap

• Disconnect the bag from the catheter with some

absorbent tissue under the join

• Keep the catheter pinched to prevent leakage

• Pick up the new bag, shake off the cap and

connect firmly to the catheter

• Now wash and dry your hands

Page 8
Storage and Disposal
It is important to store spare drainage bags in their
original packaging in a dry, safe place away from direct
heat and sunlight.

Before throwing away your drainage bag, empty it and

tie it in a plastic bag and place in the dustbin.

Do not burn the bags on an open fire or flush down the

toilet.

Supplies
Your nurse on the ward or your community nurse will
help you to find a catheter and bag system that suits
your individual needs.

Most of the equipment you require is available on

prescription from your family doctor.

Page 9
Personal Hygiene
It is easy to acquire an infection when you have a
catheter; so remember:

• Until the tract in your abdominal wall is

established, there may be a dressing around the
catheter. When you are first leave hospital, we will
provide you with your first five dressings and tape.
Your District Nurse provides you with dressings
after this.

• It does not need to be covered with a dressing

unless there is a discharge. When not covered,
wash the skin gently around where the catheter
enters your body at least once a day. Cool boiled
water is adequate.

• Dry the area thoroughly and do not use talcum

powder, creams or antiseptics unless prescribed
by your doctor or nurse.

• Wash your hands before and after connecting or

changing the drainage bags and after every bowel
motion.

• Try to have a bath or shower every day (keep your

leg bag attached to the catheter). Afterwards, the
bag can be patted dry with a towel. A fresh pair of
dry straps may be needed.

Page 10
Diet and fluids
When you get home, you should drink twice as much
fluid as you would normally for the next 24 to 48 hours to
flush your system through and minimise any bleeding.

After this time, to help the catheter drain well, you need
to drink at least 8 to 10 cups of fluid a day. Water and
fruit juice are very good.

Your normal diet is fine as long as you can avoid

constipation as a full bowel can press on the catheter
and prevent the urine flowing properly.

Sex
A suprapubic catheter should be easy to manage. It may
help to tape the catheter out of the way along your
abdomen.

Page 11
Possible Problems
The following problems can be addressed by your
community nurse.

When a catheter has just been fitted, the feeling of

needing to pass urine is usually due to a mild bladder
irritation. The occurrence of bladder spasm or cramps
may occur from time to time but should settle in a day or
two.

If urine leaks around the outside of the catheter as a

result of the spasm, consult your nurse or doctor once
you have checked that it is not being caused by
something as simple as the bag getting too full, or that
your bag is pulling on the catheter.

Urine may occasionally leak through the urethra, the

passage through which you normally pass urine. This
again is probably due to bladder spasm. Check that the
catheter is draining correctly.

If urine is not draining, there are some things you can do

yourself:

• Ensure there are no kinks in the tubing

• Check the bag is below the level of your bladder

Page 12
When to Call for Help
Contact your community nurse or doctor in the day or
ring the emergency phone number at night if:

• You have a prolonged pain or cramps

• If urine is still not draining after two to three hours

• If there is blood in your urine and it does not clear

after drinking extra fluids

• If your urine feels as if it is burning and it does not

improve after drinking extra fluids

• If urine keeps leaking around the catheter

• If your catheter falls out, you must phone

immediately, otherwise the opening used for the
catheter may close up and you will return to having
your original problems with passing urine.

It is helpful to keep a spare catheter in the house in case

of emergency. Ask your District (Community) Nurse
about this.

Once you are discharged home, your district nurse will

oversee your care regarding your suprapubic catheter.
This will be booked by the nurses on the ward prior to
your discharge home.

Page 13
The first change of your suprapubic Catheter is normally
organised by the hospital and is performed by the
urology team.

You will receive an appointment date in the post for this

between 8 – 12 weeks after the catheter is inserted.
Please contact the urology specialist nurses if you have
not received an appointment for your change by 10
weeks from the date it was inserted.

Catheter changes do not involve a general anaesthetic.

After your first change, further changes are done by your

district nurse. You may need to contact them after your
first change so they can make a note of when they need
to come and do a home visit for the next catheter
change.

Some of the content in this leaflet has been reproduced

with kind permission of The British Association of
Urological Surgeons.

Page 14
Tell us what you think of this leaflet
We hope that you found this leaflet helpful. If you would
like to tell us what you think, please contact:
the Urology Nurse Specialist, Specialist Nurses Office,
3rd Floor, Admin Block, York Hospital, Wigginton Road,
York, YO31 8HE or telephone 01904 726315.

Teaching, training and research

Our Trust is committed to teaching, training and
research to support the development of health and
healthcare in our community. Healthcare students may
observe consultations for this purpose. You can opt out if
you do not want students to observe. We may also ask
you if you would like to be involved in our research.

Patient Advice and Liaison Service

(PALS)
PALS offers impartial advice and assistance to patients,
their relatives, friends and carers. We can listen to
feedback (positive or negative), answer questions and
help resolve any concerns about Trust services.
PALS can be contacted on 01904 726262, or email
[email protected].
An answer phone is available out of hours.

Page 15
Leaflets in alternative languages or
formats
If you would like this information in a different format,
including braille or easy read, or translated into a
different language, please speak to a member of staff in
the ward or department providing your care.

Patient Information Leaflets can be accessed via the

Trust’s Patient Information Leaflet website:
www.yorkhospitals.nhs.uk/your-visit/patient-information-
leaflets/

Owner Urology Nurse Specialist

Date first issued March 2014
Review Date July 2027
Version 5 (issued July 2024)
Approved by Sarah Hillery, Urology Advanced Nurse Practitioner NMP
Document Reference PIL587 v5
© 2024 York and Scarborough Teaching Hospitals NHS Foundation Trust.
All Rights reserved.

www.yorkhospitals.nhs.uk